In response to demands from Congress, the military healthcare systems — including Fort Hood’s Carl R. Darnall Army Medical Center — will change from management by individual military departments to the oversight of the Defense Health Agency, according to Kevin Dwyer, chief of DHA media operations.

“As part of the National Defense Authorization Acts for Fiscal Years 2017, 2018 and 2019, Congress called for changes in the military health system,” Dwyer said. “These changes redefine the roles of the Defense Health Agency and the military departments, specifically addressing the administration and management of military hospitals and clinics.”

All military hospitals and clinics must transition to direct supervision by the Defense Health Agency by Sept. 30, 2021, to create a more integrated, efficient and effective system of readiness and health and better support military members, Dwyer said.

Darnall will transition to DHA on Oct. 1.

The goal of the transition is to maximize efficiencies and improve performance of military hospitals and clinics, Dwyer said.

Under the previous, less centralized management, different policies have been enforced from hospital to hospital.

For instance, at Landstuhl Regional Medical Center in Germany, parents were allowed to hold their children in their lap and secure their arms and legs during vaccinations, however, at Darnall, parents are told by medical staff it is against hospital policy to hold the child during vaccinations; rather the child must be held down on the table in the pediatric clinic during the shots.

Although the benefit of the new management is to have more cohesive policies across all military facilities — including all the branches, Dwyer said military service members and their dependents should not notice specific changes.

“For patients, these reforms should have little or no immediate effect on their experience of care — their facility, physicians, and coverage will remain the same,” Dwyer said. “Over time, these reforms will drive better integration and standardization of care.”

Patients will have a consistent, high-quality health care experience, no matter where they are, Dwyer said. Throughout the transition, DHA is committed to supporting the soldiers and their families, he said.

“Following the transition, DHA is responsible for health care delivery and business operations across the military health services,” Dwyer said. “It will provide guidance to facilities across the enterprise in all matters related to budget, information technology, health care administration and management, administrative policies and procedures, military medical construction, as well as any other matters the Secretary of Defense determines appropriate.”

The transition began Oct. 1, 2018, when the hospitals and clinics at Fort Bragg, Pope Field, and Seymour Johnson Air Force Base in North Carolina; Naval Air Station Jacksonville, Florida; Keesler Air Force Base, Mississippi; and Joint Base Charleston, South Carolina, transitioned to DHA, he said.

“These are in addition to DHA’s authority, direction, and control over Walter Reed National Military Medical Center in Bethesda, Maryland, and Fort Belvoir Community Hospital, Virginia, and their associated clinics,” Dwyer said.

Hospitals and clinics will have one military officer serving as both the military treatment facility director, under the Defense Health Agency and the service commander, under the authority of the military department concerned, he said.

“Once the Defense Health Agency finalizes plans for civilian human resources support, civilian and contract personnel who support health care delivery functions in the hospital or clinic will be appointed, contracted for, and managed by the Defense Health Agency,” Dwyer said.

All civilian and contract personnel who support the operational readiness mission will be appointed, contracted for, and managed by the military departments, he said.

“As plans are refined to shift uniformed positions; the Office of Health Affairs, the Defense Health Agency and the services are working to analyze the need for health services, assess any gaps left by the reductions in uniformed personnel, and develop and implement plans to swiftly address those gaps,” Dwyer said. “These plans may draw on using civilian federal employees or contract personnel at military hospitals and clinics, or shifting Military Health System beneficiaries to the civilian networks maintained by TRICARE’s managed care contractors.”

Analysis will be ongoing to determine specific impact in local markets and identify options to replace the capability, Dwyer said.

DHA director Vice Adm. Raquel Bono will be visiting Fort Hood on Monday and will address members of the media about the change and how it will affect military members, their families and hospital employees.

For more information about these changes, military members or dependents can visit https://health.mil.

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